Individual
JOHN RUSSOMANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
85 SEYMOUR ST, SUITE 923, HARTFORD, CT 06106-5501
(860) 247-1876
(860) 520-1379
Mailing address
2110 SILAS DEANE HWY, ROCKY HILL, CT 06067-2313
(860) 258-3480
(860) 571-6800
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
031537
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00131537500
—
CT
Enumeration date
09/12/2006
Last updated
02/08/2016
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